Statin Treatment in Patients With Stroke With Low‐Density Lipoprotein Cholesterol Levels Below 70 mg/dL-Reference-Cited by-同舟云学术

Statin Treatment in Patients With Stroke With Low‐Density Lipoprotein Cholesterol Levels Below 70 mg/dL

Published:2023-09-19 Issue:18 Volume:12 Page:
ISSN:2047-9980
Container-title:Journal of the American Heart Association
language:en
Short-container-title:JAHA

Author:

Kim Joon‐Tae¹^ORCID,Lee Ji Sung²^ORCID,Kim Beom Joon³^ORCID,Kang Jihoon³^ORCID,Lee Keon‐Joo⁴^ORCID,Park Jong‐Moo⁵,Kang Kyusik⁶^ORCID,Lee Soo Joo⁷^ORCID,Kim Jae Guk⁷^ORCID,Cha Jae‐Kwan⁸^ORCID,Kim Dae‐Hyun⁸^ORCID,Park Tai Hwan⁹^ORCID,Lee Kyungbok¹⁰^ORCID,Lee Jun¹¹^ORCID,Hong Keun‐Sik¹²^ORCID,Cho Yong‐Jin¹²^ORCID,Park Hong‐Kyun¹²^ORCID,Lee Byung‐Chul¹³^ORCID,Yu Kyung‐Ho¹³^ORCID,Oh Mi Sun¹³^ORCID,Kim Dong‐Eog¹⁴,Ryu Wi‐Sun¹⁴^ORCID,Choi Jay Chol¹⁵^ORCID,Kwon Jee‐Hyun¹⁶^ORCID,Kim Wook‐Joo¹⁶,Shin Dong‐Ick¹⁷^ORCID,Yum Kyu Sun¹⁷^ORCID,Sohn Sung Il¹⁸^ORCID,Hong Jeong‐Ho¹⁸^ORCID,Lee Sang‐Hwa¹⁹,Park Man‐Seok¹^ORCID,Choi Kang‐Ho¹^ORCID,Lee Juneyoung²⁰^ORCID,Park Kwang‐Yeol²¹^ORCID,Bae Hee‐Joon³^ORCID

Affiliation:

1. Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School Gwangju Korea

2. Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine Seoul Korea

3. Department of Neurology Cerebrovascular Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam Korea

4. Department of Neurology Korea University Guro Hospital Seoul Korea

5. Department of Neurology Uijeongbu Eulji Medical Center, Eulji University School of Medicine Uijeongbu‐si Korea

6. Department of Neurology Nowon Eulji Medical Center, Eulji University School of Medicine Seoul Korea

7. Department of Neurology Daejeon Eulji Medical Center, Eulji University School of Medicine Daejeon Korea

8. Department of Neurology Dong‐A University Hospital Busan Korea

9. Department of Neurology Seoul Medical Center Seoul Korea

10. Department of Neurology Soonchunhyang University Hospital Seoul Korea

11. Department of Neurology Yeungnam University Hospital Daegu Korea

12. Department of Neurology Ilsan Paik Hospital, Inje University Goyang Korea

13. Department of Neurology Hallym University Sacred Heart Hospital Anyang Korea

14. Department of Neurology Dongguk University Ilsan Hospital Goyang Korea

15. Department of Neurology Jeju National University Hospital, Jeju National University School of Medicine Jeju Korea

16. Department of Neurology Ulsan University College of Medicine Ulsan Korea

17. Department of Neurology Chungbuk National University Hospital Cheongju Korea

18. Department of Neurology Keimyung University Dongsan Medical Center Daegu Korea

19. Department of Neurology Hallym University Chuncheon Sacred Heart Hospital Chuncheon‐si Gangwon‐do Republic of Korea

20. Department of Biostatistics Korea University College of Medicine Seoul Korea

21. Department of Neurology Chung‐Ang University College of Medicine, Chung‐Ang University Hospital Seoul Korea

Abstract

Background It is unclear whether statin treatment could reduce the risk of early vascular events when baseline low‐density lipoprotein cholesterol (LDL‐C) levels are already low, at <70 mg/dL, at the time of the index stroke. Methods and Results This study was an analysis of a prospective, multicenter, nationwide registry of consecutive patients with first‐ever acute ischemic stroke with baseline low‐density lipoprotein cholesterol levels <70 mg/dL and without statin pretreatment. An inverse probabilities of treatment weights method was applied to control for imbalances in baseline characteristics. The primary outcome was a composite of stroke (either hemorrhagic or ischemic), myocardial infarction, and all‐cause death within 3 months. A total of 2850 patients (age, 69.5±13.4 years; men, 63.5%) were analyzed for this study. In‐hospital statin treatment was used for 74.2% of patients. The primary composite outcome within 3 months occurred in 21.5% of patients in the nonstatin group and 6.7% of patients in the statin group ( P <0.001), but the rates of stroke (2.65% versus 2.33%), hemorrhagic stroke (0.16% versus 0.10%), and myocardial infarction (0.73% versus 0.19%) were not significantly different between the 2 groups. After inverse probability of treatment weighting analysis, the primary composite outcome was significantly reduced in patients with statin therapy (weighted hazard ratio [HR], 0.54 [95% CI, 0.42–0.69]). However, statin treatment did not increase the risk of hemorrhagic stroke (weighted HR, 1.11 [95% CI, 0.10–12.28]). Conclusions Approximately three‐quarters of the patients with first‐ever ischemic stroke with baseline low‐density lipoprotein cholesterol levels <70 mg/dL received in‐hospital statin treatment. Statin treatment, compared with no statin treatment, was significantly associated with a reduced risk of the 3‐month primary composite outcomes and all‐cause death but did not alter the rate of stroke recurrence.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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